Ann Arbor Classification

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The Ann Arbor staging is in the medicine used to malignant lymphoma , so malignant diseases of the lymphatic system to classify . This is used to determine the degree of spread and ultimately also determines the further course of treatment. The stage, general symptoms and extralymphatic infestation are recorded. The infestation of individual organs is usually not registered. Although it was originally developed for Hodgkin lymphomas , it is now used for non-Hodgkin lymphomas as well.

The classification, however, does not provide any information about the degree of the tumor , i.e. how far it differs from normal tissue.

Stages

A distinction is made between four main stages, which are marked with the Roman numerals I to IV. They provide information about the spread of the tumor.

stage Pattern of involvement of the lymph nodes
I. Involvement of only one lymph node region
II1 Involvement of two neighboring lymph node regions on only one side of the diaphragm , i.e. either above or below
II2 Involvement of two non-adjacent or more than two adjacent lymph node regions either above or below the diaphragm
III Involvement of lymph node regions above and below the diaphragm
IV diffuse or disseminated involvement of lymph nodes and extralymphatic tissues

In addition, letters can be added to the stage to reflect the diagnosis more precisely:

  • E for infestation of extranodal organs or spread from lymph nodes into surrounding tissue.
  • S when the spleen (gr. Σπλήν, splēn) is affected (usually only in stage III).
  • X called. Bulk or bulky disease will be used if the maximum diameter of the tumor in adults cm exceeds 10, or the mediastinum in a X-ray of the thorax occupies one third of the maximum horizontal diameter thorax.
  • A or B , where A stands for no general symptoms, while B indicates the presence of general symptoms ( fever > 38 ° C, night sweats , weight loss [unintentional,> 10% of body weight in 6 months]). This triad is also known as the B symptoms .

history

The Ann Arbor classification is named after Ann Arbor , Michigan, USA, the city in which it was developed by a committee of international experts in 1971. It replaced the Rye classification developed in 1965 . In 1988, after a meeting in Cotswold , England, the Cotswold modification took place .

See also

literature

  • Gerd Herold : Internal Medicine . Cologne 2005
  • Gerd Herold: Internal medicine: a lecture-oriented presentation . Cologne 2012, ISBN 978-3-9814660-1-0 , p. 66, 70 .

Individual evidence

  1. ^ Paul P. Carbone: Citation classics . (PDF; 253 kB) In: Current Contents / Clinical Practice , 1983, 50, p. 22; on the influence of the Ann Arbor classification